Karoshi is death from overwork

Burnout is chronic exhaustion due to excessive or demanding work. Lost of motivation can also result. There can also be physical symptoms such as sleep irregularity and chronic fatigue. The excessive or demanding work take a physical toll on the physical body. Stress can deplete vital vitamins and minerals such as magnesium, especially if the worker is eating fast food and not eating a balanced healthy meal due to time constraints.

Burnout is not too much different from being demoralized. Except that burnout is more physical and demoralization is more emotional. Demoralization is when the worker do not want to work due to one reason or another. Burnout can be when the worker still wants to work to accomplish a goal. But there is just so much work and so little time and the body can only work so much.

When workers neglect to give the physical body the rest and restoration that it needs, it increases the chance of burnout.

Burnout is the body trying to tell the worker that he or she should stop. But when burnout is endured too long or if the worker refuses to listen to the body, it can lead to karoshi which literally means “death by overwork”.


“Burnout” is condition found in the 2012 ICD-10-CM Diagnosis Code. ICD-10 is the International Classification of Disease. In particular, it is ICD code Z73.0, under the more generalized category of Z73 titled “Problems related to life management difficulty”.

One measurement of burnout is the Maslach Burnout Inventory (MBI) which takes into account “emotional exhaustion”, “depersonalization”, and “personal accomplishment”.

It is debatable as to which jobs has the highest rates of burnout. But there are many reports that general medical practitioner experience very high burnout rates (over 30% burnout rates). For example …

Wikipedia even goes as far as to say …

“Research indicates general practitioners have the highest proportion of burnout cases”

This is not surprising given the long hours that doctors and residents work and many of which are not getting enough sleep.

What is worst is that even back in 2003, MSNBC reported that job stress and burnout is on the rise.[2] Again this is not surprising since middle Americans are working longer hours in order to make ends meet than generations ago.

Ernie Zelinski writes in The Joy of Not Working

“The detrimental consequences of the mad world of corporate life are far-reaching. In the frenzy of hard work and day-to-day survival, many employees have lost their personal dreams. Their overwork leads to deprived family lives, forgotten social lives, even separation or divorce. For those feeling burnout, there is no more purpose, meaning, or zest for living.” [page 43]

Karoshi – Death from Overwork

Not only do those with burnout have no zest for living, some actually die unexpectedly.

Technically, the cause of death may be a heart attack or stroke. But the root cause may be due to stress and overwork. The Japanese term Karoshi literally means “death from overwork”. This does happen. There are many news reports of people dying from overwork. And if you do a web search on karoshi in the news, you can find instances of such cases. There are karoshi hotlines as well as lawsuits related karoshi deaths.

There is a correlation between overwork and cardiovascular disease. The European Heart Journal reports that people who work long hours (such as 10 to 11 hours a day) have a 60% higher cardiovasular risk.[5]

Although Japan and possibly other countries may be keeping records of Karoshi deaths, the numbers are not readily available. And there are always many more cases that goes unreported. In addition, there will be a number of people who get severely ill, mentally ill, or commit suicide.[3]

Death from overwork is real

Karoshi is a real phenomenon with the first incident reported in 1969. And there have been reports in the news since then. See YouTube videoof one such news report.

There are Karoshi Exhibition which display suicide notes by workers.

HuffingtonPost article reports of 2nd incident in a year where a Toyota workers have died of Karoshi. Article shows pictures of Japanese commuters so tired that they sleep during train commutes sometimes while standing.

Internet forum are talking about Karoshi and about how stressful working life is in Japan.

According to Wikipedia, Japan is among the countries with high suicide rate at around 23.8 suicides per 100,000 people per year (for 2011). This is 7th highest in the world. Although not all of these are due to karoshi.

Jobs with High Suicide Rates

The jobs that leads to the most suicide is again up for debate. But some findings are as follows.

In 1995, the National Institute of Occupational Safety and Health (NIOSH) found higher suicide rates in the medical field.[reference] Not surprising since they have high burnout.

BusinessInsider.com reports in 2011 the following jobs with the highest suicide rates:

  • Marine engineers (1.89 times more likely to commit suicide)
  • Physicians (1.87 times more likely to commit suicide)
  • Dentists (1.67 times more likely)
  • Veterinarians
  • Finance workers
  • Chiropractors
  • Supervisors of heavy construction equipment
  • Urban planners
  • Hand molders
  • Real estate sellers
  • Electrical Equipment assemblers
  • Lawyers
  • Lathe operators
  • Farm managers
  • Heat Treatment operators
  • Electricians
  • Precision woodworkers
  • Pharmacists
  • Natural scientists (are 1.28 times more likely to commit suicide)


Karoshi Game

There is a game designed by Jesse Venbruz and published for Mac, Flash, iOS, Android, and PSP based on the Japanese work Karoshi. There is also a mobile version published by YoYo Games.

In this puzzle game, you maneuver a salaryman (named My. Karoshi) with the goal of committing suicide supposedly because the salaryman is sick of corporate life. Containing dark humor, parody of the corporate environment, and puzzle gameplay, this game has received much acclaim and is quite popular. It placed 5th in Wired’s top PC games of 2008. Other awards include “internet game of the month” by EDGE Magazine.


We are reminded of the old adage: “Work to live; not live to work”. And definitely, do not die for work.

So when your body start giving you the warning light with burnout symptoms, listen to it and stop. If you continue driving, it is like driving with your low-oil warning light on in your car. It is going to burn out your engine.

Leo Babauta of ZenHabits.net gives us four ways to not become a work-aholic:

1. Don’t be achievement-motivated.
2. Don’t be a workaholic.
3. Learn to relax and de-stress.
4. Learn to feel good about it.

Or read The Joy of Not Working.